Jacklin R K, Ridgway P F, Ziprin P, Healy V, Hadjiminas D, Darzi A
Department of Surgical Oncology and Technology, Imperial College, London, UK.
J Clin Pathol. 2006 May;59(5):454-9. doi: 10.1136/jcp.2005.025866. Epub 2006 Feb 6.
The role of the pathologist in the preoperative diagnosis of phyllodes tumours of the breast is critical to appropriate surgical planning. However, reliable differentiation of phyllodes tumour from cellular fibroadenoma remains difficult. Preoperative diagnostic accuracy allows correct surgical treatment, avoiding the pitfalls of reoperation because of inadequate excision, or surgical overtreatment. Specific clinical indices may arouse diagnostic suspicion but are unreliable for confirmation, as with current imaging modes. Fine needle aspiration cytology has a high false negative rate. Few studies have evaluated the role of core needle biopsy, but it may prove a useful adjunct. Both diagnostic and prognostic information may in future be gained from application of immunohistochemical and other techniques assessing the expression of proliferative markers including p53, Ki-67, and others.
病理学家在乳腺叶状肿瘤术前诊断中的作用对于恰当的手术规划至关重要。然而，将叶状肿瘤与富于细胞性纤维腺瘤可靠地区分开来仍然具有挑战性。术前诊断的准确性有助于实施正确的手术治疗，避免因切除不充分而再次手术或手术过度治疗的陷阱。特定的临床指标可能引发诊断怀疑，但如同当前的成像模式一样，对于确诊并不可靠。细针穿刺细胞学检查的假阴性率很高。很少有研究评估粗针活检的作用，但它可能被证明是一种有用的辅助手段。未来，通过应用免疫组织化学和其他评估包括p53、Ki-67等增殖标志物表达的技术，可能会获得诊断和预后信息。
